Management of tracheal perforations: Potential complications and pitfalls

Prange, Timo

doi:10.1111/eve.12472

Cited by 6 publications

(9 citation statements)

References 22 publications

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“…Pneumomediastinum was diagnosed, radiographically, in the current case. This modality has been referred to as the primary modality to identify air in the mediastinum and the pleural cavity (Prange, 2015).…”

Section: Discussionmentioning

confidence: 99%

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Pneumoperitoneum as an uncommon complication after an axillary laceration in a horse

Schoen

Naem

Geburek

et al. 2022

Veterinary Medicine & Sci

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Lacerations of the axillary region occur frequently in horses. Typical complications caused by entrapment of air in the wound during locomotion are subcutaneous emphysema, with consecutive pneumomediastinum and pneumothorax. In this case report, the clinical, radiographic and laboratory diagnosis and management of these complications after an axillary laceration that finally resulted in pneumoperitoneum are described. A 1-year-old Hannoveranian was presented with a pre-existing axillary laceration of unknown duration and subcutaneous emphysema in the surrounding tissue.Due to extensive tissue loss, attempts to adequately close the wound surgically and by packing with sterile dressing material were unsuccessful. Despite stall confinement and tying of the horse, subcutaneous emphysema was progressive and pneumomediastinum as well as pneumothorax was developed. These complications were monitored radiographically. On day 5 after admission, signs of air accumulation were detected on radiographs craniodorsally in the peritoneum and a pneumoperitoneum was diagnosed. Repeated thoracentesis with a teat cannula to gradually evacuate the thoracic cavity was used in combination with nasal oxygen insufflation to treat global respiratory insufficiency. Subcutaneous emphysema and all other complications resolved progressively and the horse was discharged from the hospital 21 days after admission when the axillary wound was adequately filled with granulation tissue. The wound healed fully 1 month later and the horse did not develop long-term complications within the following year. To the authorst' knowledge, the development of pneumoperitoneum including its radiographic monitoring following an axillary laceration has not been described in horses previously.

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Section: Discussionmentioning

confidence: 99%

“…Ultrasound is not adequate to visualise the mediastinum, due to the surrounding aerated lungs (Prange, 2015).…”

Section: Discussionmentioning

confidence: 99%

Pneumoperitoneum as an uncommon complication after an axillary laceration in a horse

Schoen

Naem

Geburek

et al. 2022

Veterinary Medicine & Sci

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“…Most small tracheal lesions (1-3 mm) rapidly form a fibrin seal and resolve spontaneously with conservative management (Scott 1978). Other treatment options have been described, for example, creating an incision in the skin and soft tissue over the tracheal defect to release trapped air and therefore prevent more air from becoming trapped in the subcutaneous tissue or performing tracheostomy adjacent to the defect, with both approaches being performed to allow wound healing by secondary intention (Gillen et al 2015;Prange 2015;Barber 2016). Additionally, the use of a fibrin glue sealant to close a dorsal tracheal defect (Coco et al 2018) has recently been described.…”

Section: Discussionmentioning

confidence: 99%

Open approach to correct traumatic closed tracheal lacerations: A case series

Iglesias-García

Lepage

Calvo

et al. 2020

Equine Veterinary Education

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Reports of tracheal injuries in horses are rare compared with those in small animals and humans. Although uncommon, tracheal injuries can be life threatening if they progress or are not treated. Different treatments have been described depending on the severity of the problem. This report describes the successful surgical treatment of three cases of closed tracheal lacerations through an intraluminal surgical approach.

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“…Although subcutaneous emphysema is usually regarded as a sign secondary to an underlying problem, it is recommended to treat it, as it can lead to complications such as life‐threatening pneumothorax, pneumomediastinum (Hance and Robertson ; Prange ) and skin necrosis as a sequela of the separation of the dermal layers.…”

Section: Discussionmentioning

confidence: 99%